The most common cause of spontaneous abortion is?

BSF Staff Nurse - 2015

Obstetrics & Gynaecology

Easy

Appeared in: BSF Staff Nurse - 2015

Explanation

Genetic abnormalities are the leading cause of spontaneous abortions, accounting for approximately half of all first-trimester losses.
These abnormalities are typically random errors in cell division (aneuploidy), not inherited problems from the parents.
The most common types of these errors are autosomal trisomies (an extra chromosome in a pair), such as Trisomy 16, and Monosomy X (a missing sex chromosome).
These genetic errors make the embryo non-viable, leading the body to naturally terminate the pregnancy.

Option A: While severe physical trauma can potentially lead to pregnancy loss, it is an infrequent cause of first-trimester miscarriage.
Option C: While severe, chronic stress is not beneficial during pregnancy, there is no strong evidence to suggest it is the most common cause of spontaneous abortion.
Option D: This is an outdated and less precise term. While it conceptually refers to a defect in the fertilized ovum (which is a genetic issue), 'Genetic abnormalities' is the modern, accurate medical terminology.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Spontaneous Abortion as background academic context rather than a clinical decision trigger.
Nurses have a vital role in providing emotional support and factual information to patients experiencing a miscarriage, helping to alleviate feelings of guilt by explaining that the cause is most often a non-preventable genetic issue.
A key nursing priority is assessing for and managing potential complications post-miscarriage, primarily hemorrhage and infection. This includes monitoring vital signs, vaginal bleeding, and pain levels.
What if? If a patient experiences recurrent pregnancy loss (three or more consecutive losses), the likelihood of random genetic errors decreases. The clinical investigation would then shift to explore other causes, such as parental balanced translocation, uterine anatomical defects, or maternal autoimmune disorders like antiphospholipid syndrome.

How to Approach the Question

First, identify the core of the question, which asks for the 'most common cause' of 'spontaneous abortion'.
This is a factual recall question that requires knowledge of obstetrics and pathophysiology.
Evaluate each option based on its statistical prevalence. Consider the different stages of pregnancy.
Recall that fetal factors, specifically non-viable genetic makeups, are the predominant reason for pregnancy failure, especially in the first trimester.
Eliminate options that are known to be less frequent causes, such as physical trauma and stress.
Compare 'Genetic abnormalities' and 'Germ plasm defect'. Recognize that the former is the current, precise medical term, making it the best answer.

Concept Tested & Keywords

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E6 Pathology-Vandana Puri & Kavita Gaur Textbook of Pathology and Genetics p. 523-525

E6 Gynecology Williams p. 142-173